Mishra Navya, Bharadwaj Avnish
Anesthesiology, Mahatma Gandhi Medical College and Hospital, Jaipur, IND.
Cureus. 2020 Sep 1;12(9):e10178. doi: 10.7759/cureus.10178.
Background and aim The primary aim of the study was to compare the intubation characteristics and effectiveness of intubating laryngeal mask airway (ILMA) and Ambu® Aura-i™ as a conduit for facilitating fiberoptic-guided intubation. Methods Eighty patients were enrolled in the randomized-controlled hospital-based study. After inducing general anesthesia, an appropriately sized ILMA (group 1)/Ambu Aura-I (group 2) was placed. Fiberoptic assessment of the glottic view was done followed by fiberoptic-guided tracheal intubation. The time taken for the insertion of ILMA/Ambu Aura-i, glottic view grading, time taken for fiberoptic-guided intubation, ease of intubation, time taken for the removal of ILMA/Ambu Aura-i were recorded. Data analysis was done using the two-tailed independent t-test, paired t-test, and Fisher's exact probability test. Result Anthropometric and airway parameters were similar in both groups. The success rate of the insertion of both devices was 100%. In group 1, the mean time taken for the insertion was 20.53±1.91, and it was 13.98±2.4 in group 2 (P<0.001S). Fiberoptic assessment of the glottic view in group 1 (ILMA group) was grade 1 in 80% of the patients, whereas it was 92% in group 2 (Ambu Aura-i) (P=0.54). The mean time taken for fiberoptic-guided intubation was 14.95±1.85 in group 1 and 14.15±1.37 in group 2 (P>0.001). No significant difference was observed according to the number of attempts in intubating through ILMA/Ambu Aura-i. Seventy-five percent (75%) in group 1 and 87.5% in group 2 were successfully inserted on the first attempt (𝑝 = 0.33). The time taken for the removal of the device was 11.87 +1.265 seconds in group 1 and 11.25±1.58 seconds in group 2 (P=0.054). Conclusion The Ambu Aura-i scores superiorly over ILMA in requiring less time for successful insertion on the basis of statistical analysis and hence appears to be a better independent ventilatory device.
本研究的主要目的是比较喉罩气道插管(ILMA)和Ambu® Aura-i™作为便于纤维支气管镜引导插管的导管时的插管特性和有效性。方法:80例患者纳入了这项基于医院的随机对照研究。诱导全身麻醉后,置入尺寸合适的ILMA(第1组)/Ambu Aura-I(第2组)。进行纤维支气管镜评估声门视野,随后进行纤维支气管镜引导下气管插管。记录插入ILMA/Ambu Aura-i的时间、声门视野分级、纤维支气管镜引导插管的时间、插管难易程度、移除ILMA/Ambu Aura-i的时间。采用双尾独立t检验、配对t检验和Fisher确切概率检验进行数据分析。结果:两组患者的人体测量学和气道参数相似。两种装置的插入成功率均为100%。第1组的平均插入时间为20.53±1.91秒,第2组为13.98±2.4秒(P<0.001)。第1组(ILMA组)80%的患者纤维支气管镜评估声门视野为1级,而第2组(Ambu Aura-i)为92%(P=0.54)。第1组纤维支气管镜引导插管的平均时间为14.95±1.85秒,第组为14.15±1.37秒(P>0.001)。通过ILMA/Ambu Aura-i插管的尝试次数方面未观察到显著差异。第1组75%、第2组87.5%的患者首次尝试即成功插入(P = 0.33)。第1组移除装置的时间为11.87 +1.265秒,第2组为11.25±1.58秒(P=0.054)。结论:基于统计分析,Ambu Aura-i在成功插入所需时间方面优于ILMA,因此似乎是一种更好的独立通气装置。